Product-line billing operation features
Product-line billing operation features
Here’s how to transform your practice
The following are typical functions, characteristics, and responsibilities of a group practice’s billing office organized by product line, according to consultants Heather Auld and Donna Sherwin of Physician Billing Solutions of Wayne, PA. (See related story on p. 20 for more details on this concept.)
• While patient scheduling and registration remains the responsibility of workers on the so-called front end of the billing process, these front-end employees are accountable to product-line managers for the accuracy of the information they provide.
• For larger, multispecialty groups, each specialty can be a different product line. Depending on the group’s size and number of specialties, the account lines can be divided among different designated product line billing managers. You can divvy up the different product lines by provider, by location (inpatient vs. outpatient), or by experience (senior vs. junior line managers).
• Each manager is responsible for the charge entry claims processing, rejection posting, resolution and follow-up of all claims in their individual product areas.
• One product manager is assigned primary responsibility for all main billing and accounts receivable functions.
• To facilitate proper preparation of electronic claims, inpatient charge entry responsibilities are moved from data entry to a product line manager. "Because of the complexity of some modifiers, it’s very helpful to have a more experienced person who’s more conversant with the billing and bundling process to be in charge," notes Auld.
• Each product manager reviews errors in paper and electronic payments in their product lines for ways to resolve and prevent them from happening in the future.
• Each product manager reviews outstanding payments in his or her product area in order to prioritize accounts receivable. The exception is for self-pay patients, which are tracked by one centralized billing associate. This avoids having different managers from several specialty product areas calling the patient.
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